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How AI can go astray with little warning
AI algorithms used in healthcare often work extremely well in early testing. But what happens in the years following their introduction into a clinical setting? A new STAT experiment conducted with a team of researchers from Massachusetts Institute of Technology Jameel Clinic found that popular algorithms for predicting sepsis and length of stay failed to keep up with ever-changing clinical conditions, leading to erroneous advice on the care of critically ill patients. The experiment, born of a unique collaboration between journalism and science, traced their demise to specific technical and operational changes that fundamentally altered the data the algorithms were analyzing about patients at Beth Israel Deaconess Medical Center between 2008 and 2019.
“Often in healthcare it has been perceived that AI or machine learning algorithms are one and the same. I build the rules and put them into production and forever it’s going to be awesome,” Andrew Merrill , director of data science at Utah Intermountain Health Care, Casey said. “But you need to have visibility into its performance over time.”
In one new investigation based on the experience, Casey explores the origins of their performance issues and the implications for the governance of AI algorithms within healthcare systems. For a deeper dive into the details, you can also read a technical supplement which explains how the algorithms were built and tested, as well as the limitations of the results.
Teladoc strikes deal with Amazon, but could suffer loss on Livongo
Teladoc signed an agreement provide non-emergency medical care on from Amazon Echo smart speakers. To access care, customers can simply say “Alexa, I want to speak to a doctor,” and they will be routed through Teladoc’s call center to seek care for minor medical issues, such as cold symptoms and flu and allergies. Tours will be audio-only, but parties say video capabilities will be available soon. While the deal grabbed headlines, not all news was positive for Teladoc on Monday, according to Business Insider. reported that the company could incur a big financial loss from its $13.9 billion acquisition of Livongo. Difficulties with acquisition may mean that Teladoc finds it harder than expected to expand its services into more complex care.
The role of digital health in the next pandemic
Despite all the gains in digital health during the pandemic, technology has largely failed to make a dent in the way of the coronavirus. A rapidly convened global digital health summit in 2020 resulted in the Riyadh Declaration on Digital Health — a list of nine guiding principles for deploying the technology against current and future pandemics — but did not address how to implement those ideas, as noted by a group of international leaders and health experts in a consensus statement in Open JAMA Network. With representatives from Finland, Saudi Arabia, Singapore, etc., the reconvened leaders laid out more practical measures to meet the challenge of the next pandemic. The goals are still ambitious – good luck implementing “standards for data sharing and a standard global minimum data set for reporting public health data” – but it’s a step forward.
ONC reports 299 information blocking allegations
OFFICE OF THE NATIONAL COORDINATOR
The Office of the National Coordinator of Health Informatics reported it has received nearly 300 information blocking complaints since it introduced new rules banning the practice last April. Information blocking occurs when healthcare entities fail to share the information necessary to provide timely and effective care to patients, or simply prevent patients from accessing data about their care. A breakdown posted online by the agency shows that most complaints are to vendors (211), followed by healthcare IT developers. The ONC said it plans to update the tally every month in line. It is not yet clear what percentage of complaints are justified.
Good evidence is just good business
In the world of digital therapeutics, reference randomized controlled trials are still rare. But a new comment written by SVC Health Chief Medical Officer and Executive Vice President Troyen A. Brennan, as well as from Harvard John Torous and great health Colin Espie, urges the field to double down on clinical evidence if it wants to succeed. “Some people would say that this evidence will be difficult to develop,” Brennan told STAT. “My answer to that is you’re going to be able to sell more products if you have that kind of evidence. So it’s just a matter of common business sense. (On a related note: Torous recently announcement he would start his own business focused on student mental health.)
An RCT, the authors say, could also help define what even qualifies as digital therapy — a phrase often used to describe everything from prescription-only tools to treat specific disorders to general-purpose wellness apps. . Read more in the latest Mario.
In other news…
- QventusCommenta maker of AI software for healthcare operations, raised $50 million in a funding round led by Thomas H. Lee Partners and Premier Inc.. The company, which works with suppliers such as Boston Medical Center and Saint-Luc Health Systemseeks to extend its services to new customers.
- Epitela Salt Lake City-based company developing a wireless EEG to detect seizures, raised $12.5 million in a Series A round led by Catalyst Health Ventures and Genoa companies. The company plans to use the money to fuel initial sales in select markets.
- The new AI of medical imaging Viz.ai landed a new FDA clearance for an algorithm designed to detect brain aneurysms. The company previously won agency approval for an AI tool that flags suspicious strokes and speeds up notifications to specialists.
- The Health Analytics Society GoodSky East to acquire TapCloud, creator of an app that allows patients to report symptoms and communicate with providers. The transaction will expand WellSky’s data wealth with patient-reported outcome information.
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